Individual provider Active NPI

Darilou Dee Potter, NCC-BC LPC LMHC

  • Professional Counselor
  • Salem, OR
National Provider Identifier
1689625444
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
1675 Winter St NE
Salem, OR 97303
Phone
(503) 585-0351
Fax
(503) 585-0212
NPI assigned
May 15, 2006
Last updated
Jan 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH00006910 WA
Mental Health Counselor 101YM0800X C1643 OR
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

1675 Winter St NE
Salem, OR 97303

Mailing address

4743 Fir Dell Dr SE
Salem, OR 97302-4812
Phone (503) 332-6134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231227001748 OR Practitioner - Mental Health Counselor 7810347283

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LH00006910WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Colorado, P.C. PastSince Jan 1, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1689625444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4743 FIR DELL DR SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024812",
            "telephone_number": "503-332-6134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 WINTER ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97303",
            "telephone_number": "503-585-0351",
            "fax_number": "503-585-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "DARILOU",
        "middle_name": "DEE",
        "credential": "NCC-BC  LPC LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00006910",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C1643",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.